Self Assessment

2015 - 2015 - Final NURS - 208 Course Learning Outcomes (201509)

NUR 208 Practical Nursing Practice 4 (PN, 06-Sep-2015 - 31-Dec-2015)
Student :
Clinical Teacher/Preceptor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Period :
Student hours :
Required Hours :
Validated hours :

Talha Z. Zafar
Elaine Willard
Judy Martin
William Osler Health Centre/Etobicoke General
Hospital
Agency
8E Orthopedics
06-Sep-2015 To 31-Dec-2015
168
168
156

Teacher comment for validated hours:

Absent week 13 December 4, 2015.
Student decision to return home ill at approximately 0800 hrs.
I declare that this is my original work and the sources used are acknowledged.

Abilities and Outcomes / Learning Outcomes

Student Rating

Teacher Rating

1. COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK

1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies

Satisfactory

Satisfactory

and procedures.
T.Z.Z. : I comply with regulatory standards, relevant legislation and the practice settings policies and procedures. For example, I ensure
that my ID is visible, ensure that privacy is maintained as mandated by legislation and policies, and I introduce myself as well as my role to
patients. Before conducting a procedure, I explain the procedure and obtain consent prior to beginning the procedure.

1. 2 Act in a responsible, ethical and accountable manner.

Satisfactory

Satisfactory

T.Z.Z. : I act in a responsible, ethical and accountable manner. For example, I give/receive report at the beginning and end of shift; as well
as prior to and after returning from break. Whenever I am unsure of anything, I ask the most responsible or relevant person/authority
questions.

1. 3 Determine how the three factor and practice decision-making frameworks influence client

Satisfactory

Satisfactory

care.
T.Z.Z. : I determine how the three factor and practice decision-making frameworks influence client care.

E.W. : You also do not care for unstable clients who are assigned to an RN. Therefore, you keep within your scope of practice as a PN
student.

1. 4 Use evidence informed practice and a theory-based approach to care.

Satisfactory

Satisfactory

T.Z.Z. : I used evidence informed practice and a theory-based approach to care by ensuring that all my assessments were theory based
and all my interventions were evidence based (my assessment). I was able to perform an hourly check of the IV, from the insertion site to
the bag; I was also able to extract air bubbles from the line using the pump set up/administer IV drugs, and then demonstrate to my fellow
students. In addition, by performing a full head to toe assessment and procedures (cardio., neuro., resp., skin integrity, GU, GI, vac
dressing, suture removal, ileostomy bag change, etc ), I was able to determine any irregularities compared to patient's baseline, and I
responded appropriately by documenting the finding (under nursing notes/assessment), informing the staff nurse and the doctor.

1. 5 Carry out safety-based practices and risk management principles to ensure client safety

Satisfactory

Satisfactory

and a safe environment.

T.Z.Z. : I carry out safety-based practices and risk management principles to ensure client safety and a safe environment. For example, I
administered medication in accordance with practice standard Medication Revised 2015 and following the 10 rights of drug administration.
I researched my patient's diagnosis and history in their charts (hard/soft copy) and William Osler Net library (for surgical procedure and
diagnosis). I also consulted appropriate professionals (nurse, physio-therapist, pharmacist, etc.) in order to provide safe competent care.

1. 6 Ask questions and clarify the plan of care, unclear orders or directions, and whenever

Satisfactory

Satisfactory

uncertain.
T.Z.Z. : I collaborate with other professionals whenever I'm unsure or want clarification regarding the plan of care. For example, I sought
my instructor, staff nurse, resource nurse, pharmacist, physio-therapist and OT whenever I was unsure about a certain procedure,
documentation category and/or method of approach; as mandated by Decisions About Procedures and Authority (Revised 2014) and
Disagreeing With the Plan of Care. For example, multiple nurses informed me to document all my assessments individually only. I was also
informed by my instructor to document all my assessment under a single entry file named "physical assessment". These were two
opposing statements, therefore I consulted my instructor and the resource nurse and came to a conclusion that both ways were
acceptable; individual documentation took more time however it was more comprehensive and "physical assessment" took less time
however it was less comprehensive. After further examination and discussion amongst the three of us, I decided to document all
assessment individual because they were more comprehensive. A week later (next shift), we were told by our instructor to do the physical
assessment because she had investigated further into it and confirmed it with the education nurse that William Ostler has indeed made this
change and that it was to be implemented. This is one example of how I was able to get the most accurate information.

E.W. : Your instructor consulted with the clinical educator early on in the semester regarding this issue. There are certain levels of
authority to go through when these questions arise. The educator makes these decisions and those are the decisions that your instructor
follows. On a ward, there will always be nurses who do not abide by new procedures and continue to do things the way they wish, despite
being taught otherwise or receiving memos in their Osler email.

1. 7 Demonstrate professional behavior by seeking assistance in situations in which there is

Satisfactory

Satisfactory

unsafe,
unacceptable and/or unprofessional behavior.
T.Z.Z. : I demonstrate professional behavior by seeking assistance (instructor, staff nurse, and other professionals) in situations in which
there is unsafe, unacceptable and/or unprofessional behavior. I had created SMART goals at mid-term regarding proper reporting to ensure
safe and competent. I have been able to achieve my goal by ensuring that I always give report to staff nurse, replacement student nurse
and instructor (if the replacement student nurse is administering drugs in my absence) before leaving the floor for breaks or end of shift. I
have been able to achieve this by creating and carrying a pre-break or pre-end-of-shift check-list for each of my shifts. The checklist will
prevent such mistake as I made in the past from occurring again. In addition, I review the effectiveness of the checklist at the end of every
shift and so far it has been very effective as a tool to keep track of reports.

1. 8 Demonstrate understanding about the role of the nurse within health care.

Satisfactory

Satisfactory

T.Z.Z. : I demonstrate understanding about the role of the nurse within health care by following standards and legislation, and maintaining
competency by continuous learning and self-assessment; as evident by the creation of my learning plan and smart goals.

Teacher comments for COMPETENT AND SAFE PRACTICE WITHIN A PROFESSIONAL, LEGAL, AND ETHICAL FRAMEWORK :
Talha has consistently provided safe and competent care as the semester evolved. As he gained experience with surgical nursing and
learned the ward routines and practices , he was able to carry out his nursing care in a safe manner. His understanding of this outcome is
demonstrated by his examples from his nursing practice.

2. ACCURATE AND RELEVANT COMMUNICATION

2. 1 Participate in team sharing and discussions.

Satisfactory

Satisfactory

T.Z.Z. : I participated in the Physiotherapy and infection control in-sessions. In addition, each post conference, all student nurses did a
presentation on different topics. I have shared information on Smoking cessation and appropriate healthy teaching for the client;
demonstrated how to change ileostomy bag, how to use a pump, how to document, how to do a dressing, how to do the assessments, etc.

2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic

Satisfactory

Satisfactory

methods.
T.Z.Z. : I have done all my the assessments documentation clearly, accurately, concisely in a timely manner using written and electronic
methods. I document upon exiting my pt.'s room after performing any assessment.

2. 3 Report relevant information to the appropriate personnel.

Satisfactory

Satisfactory

T.Z.Z. : I report relevant information to the appropriate personnel of all significant findings during my assessments. I had created SMART
goals at mid-term regarding proper reporting to ensure safe and competent. I have been able to achieve my goal by ensuring that I always
give report to staff nurse, replacement student nurse and instructor (if the replacement student nurse is administering drugs in my
absence) before leaving the floor for breaks or end of shift. I have been able to achieve this by creating and carrying a pre-break or pre-endof-shift check-list for each of my shifts. The checklist will prevent such mistake as I made in the past from occurring again. In addition, I
review the effectiveness of the checklist at the end of every shift and so far it has been very effective as a tool to keep track of reports.

2. 4 Use communication techniques with the client and the inter-professional health care

Satisfactory

Satisfactory

team.
T.Z.Z. : I have allway been very professional when it comes to communication. I always try to maintain a therapeutic com. towards my pt.
One of my pt. spoke multiple languages (English, Hindi and Urdu) and another pt who spoke only Urdu. I was able to communicate to them
in their native language in a therapeutic manner improved their over all experience as mentioned by one the pt.
I was asked by one of the nursing student to assist them in providing therapeutic com. to a client who only spoke Punjabi and I was
successful.
In addition, I have always communicated with the health care team in a professional manner which was even noted by one of the staff
nurses and instructor, and mentioned to me.

2. 5 Ensure privacy and confidentiality according to the Personal Health Information

Satisfactory

Satisfactory

Protection Act (PHIPA).

T.Z.Z. : I ensure privacy and confidentiality according to the Personal Health Information Protection Act by ensuring that any notes I take
do not contain pt.'s name, date of birth, or room number. I also ensure that all patient related information is not brought home and is
deposited in the confidential shredding box. I do not talk about my patient outside of my work place.

2. 6 Use technology to retrieve and share information including research, data and other

Satisfactory

Satisfactory

information.
T.Z.Z. : I use technology to research information when needed from credible resources such as William Ostler Net, Nursing books, and
other credible site such as CNO.org, RPNAO.org, RNAO.org, etc.

Teacher comments for ACCURATE AND RELEVANT COMMUNICATION :

Talha has demonstrated good communication techniques with his patients and staff through his examples from his clinical practice. He
has mastered the Meditech documentation program and has been helpful in assisting the other students. All reporting to staff and peers
has been done well.

3. CARING RELATIONAL PRACTICE

3. 1 Use effective communication techniques.

Satisfactory

Satisfactory

T.Z.Z. : I use effective communication techniques. The techniques that I used so far are: using silence, exploring, giving recognition, using
open/closed ended questions, encouraging description of perceptions, restating, reflecting, giving information, seeking clarification,
summarizing, etc.
In addition, I have always communicated with the health care team in a professional manner.

3. 2 Establish therapeutic caring, compassionate, and culturally safe relationships with clients

Satisfactory

Satisfactory

and health care team members.

T.Z.Z. : I establish therapeutic caring, compassionate, and culturally safe relationships with clients by listening to there view and concerns,
while maintaining a respectful and non-bias attitude; and I respond and care for my client in a manner that is in client's best interest and
culturally competent, while maintaining boundaries. I also explore client's cultural preferences by engaging in a therapeutic discussion.
I demonstrate a professional behavior towards all clients and health care professionals.

3. 3 Demonstrate therapeutic use of self to foster client well-being.

Satisfactory

Satisfactory

T.Z.Z. : I provide my clients with culturally competent care that is client oriented. If there needs to be a change in self then I make that
change so that my client may get the best holistic care.

3. 4 Use self-awareness to identify the effects that beliefs, values, and personal experiences

Satisfactory

Satisfactory

have on relational practice.

T.Z.Z. : I provide my clients with culturally competent care that is client oriented. If there needs to be a change in self then I make that
change so that my client may get the best holistic care. I do that by keeping my opinion out of my decision making. The care I provide is
solely based on my clients needs; not only the priority needs, rather complementary therapy as well, such as therapeutic discussion, foot
rub, back massage, etc.

3. 5 Collaborate with clients and members of the inter-professional health care team and

Satisfactory

Satisfactory

consult appropriately.
T.Z.Z. : I collaborate and consult with clients and members of health care team appropriately. For example, presentation in post
conference, assisting nurses/student nurses with procedures, accepting help from nurses/student nurses, assisting clients in ADLs, etc.

3. 6 Support the diversity of clients and the inter-professional health care team.

Satisfactory

Satisfactory

T.Z.Z. : I demonstrate a culturally competent professional behaviour towards all clients and health care professionals. For example, I
communicated with three clients who preferred to speak in Urdu, Hindi, Punjabi and French. I have learned that no one client is the same.
Each client is unique and requires a unique care. Therefore, It is important that I adapt myself in a manner that helps me provide best
therapeutic care to my client. In addition, I maintain my professionalism and treat everyone with utmost respect and dignity.

3. 7 Display sensitivity and respect for clients cultural, religious, and other beliefs and values

Satisfactory

Satisfactory

influencing their choices and decisions.

T.Z.Z. : I display sensitivity and respect for clients cultural, religious, and other beliefs and values influencing their choices and decisions.
For example, one of my client only eats Halal foods. And the family was concerned about this issue. So I made sure that my client was
getting halal food delivered to the room. I maintain my professionalism and treat everyone with utmost respect and dignity. I always offer
choices to my client and ask for there permission. I ask for their opinion on care being provided. This helps me enhance my care plan
based on client's unique needs.

3. 8 Provide effective client education.

Satisfactory

Satisfactory

T.Z.Z. : When I engage my client in a therapeutic discussion, I am able to assess area where client needs further education and provide
them that education in a manner that they understand. I have educated each of my client in a way that they would understand and
effectively demonstrate. For example, I explained to my client why ambulation was important and what exercises client could do without
inducing pain/discomfort (and demonstrated); and then asked the client to demonstrate exercises and explain their understanding of why
ambulation was important. Using the same techniques, I've done health teaching on spirometer, ileostomy bag change, etc.

Teacher comments for CARING RELATIONAL PRACTICE :

Talha has met this outcome and has provided examples from his practice to demonstrate understanding. He is a caring student who strives
to provide the best care for his patients.

4. LEADERSHIP AND ADVOCACY

4. 1 Apply appropriate conflict resolution skills in therapeutic client and other interactions.

Satisfactory

Satisfactory

T.Z.Z. : Recognizing the situations that could lead to conflict and avoiding it by applying conflict resolution knowledge is crucial.
Communication has to transmitted and received in a non-aggressive way, while accepting that fact that everyone has a right to their
opinion and we should always strive to reach a compromise in a respectful manner. This is not that easy, I have had to work on this to
reach the point I have attained. Now I am able recognize the signs and act before the conflict. For example, I applied appropriate conflict
resolutions skills in incident with the staff nurse. I gave the staff nurse a chance to freely speak her mind and tried to understand her point
of view and responded in a professional manner that was free of antagonism. The lack of aggression from my part led to a calm discussion
and a resolution.

E.W. : There should never be aggression in the workplace, so your solution was good.

4. 2 Evaluate and refine leadership skills to develop solutions and create a positive work

Satisfactory

Satisfactory

environment.
T.Z.Z. : I always help, collaborate and demonstrate. This process helps both me and my peers to learn more effectively. For example, my
peer and I performed a ileostomy bag change. We collaborated respectfully and effectively by planning out the procedure.

4. 3 Provide feedback to peers and accept feedback from peers and members of the interprofessional health care team.

Satisfactory

Satisfactory

T.Z.Z. : I believe that the best way to improve our skills is by offering and accepting constructive criticism which is why I have welcomed
and implemented all feed back that would help me improve my approach to care. For example, My instructor felt that my facial expression
were contradicting my statements. After some self reflection, I realized that when I am focused, my facial expression are in such a state
that it's meaning maybe misconstrued in a negative manner. So I have taken that feed back positively and I attempt to be more aware of my
expressions.

4. 4 Advocate for clients, self, others, and quality practice environment.

Satisfactory

Satisfactory

T.Z.Z. : I have advocated for my client to receive timely and appropriate care, for example physio-therapy, prn drugs, privacy, etc.
I have also advocate for self and fellow students for a quality learning as mandated by the course outline.

E.W. : Could have been about 10 concept care maps according to the course outline. You submitted three thorough ones that included
assessment data, which is integral to a good concept map. It is always ultimately up to your clinical teacher how she/he wants them to be
done, especially on acute surgical patients where assessment data is critical to know.

4. 5 Support clients rights for self-determination and choice.

Satisfactory

Satisfactory

T.Z.Z. : I always offer choices to my client and ask for there permission. I ask for their opinion on care being provided.

4. 6 Respond appropriately to unsafe, unacceptable, and unprofessional behaviours.

Satisfactory

Satisfactory

T.Z.Z. : I have responded appropriately to unsafe, unacceptable, and unprofessional behaviours; such as the incident with the alcohol
swab. Otherwise, all my peers are very professional and think critically, but if a need arises then I would try to make the situation safe by
applying conflict resolution techniques or by making the physical environment safe.

E.W. : Alcohol swab incident? This indicator is about how you respond to unsafe behaviors. The professionalism and critical thinking of
your peers is not the subject.

4. 7 Collaborate and consult when implementing health care and nursing practices that are in

Satisfactory

Satisfactory

the best interests of the public and protect the public through collaboration and consultation.
T.Z.Z. : Consultation and collaboration are key in providing safe client care. For example, I collaborate with pharmacist when unsure about
a drug and drug comparability. My client had an order of a medication that he brought from home therefore it was not supplied by the
hospital (Potassium). However, my client's family member accidentally took that medication bag home. I brought this to the attention of the
staff nurse, M.D., and the pharmacist. In collaboration with the pharmacist, we were able to determine which Trade named medication
would be the same as pt.'s own medication, to be used as replacement. We procured appropriate orders as well. In addition, I have always
maintained my client's confidentiality and privacy by logging of properly, never discussing pt's information outside of circle of care
provider, ensure all notes taken by me do not have pt's information, if they do have pt's information then I make sure that it goes in the
shred box.

4. 8 Contribute to the creation of quality practice solutions and strategies.

Satisfactory

Satisfactory

T.Z.Z. : I contribute to the creation of quality practice solutions and strategies by formulating safe, effective and client oriented techniques.
For example, I created tracking sheet to keep track of all reporting. and I incorporate all the techniques that my instructor, fellow students,
and other professionals teach me.

Teacher comments for LEADERSHIP AND ADVOCACY :

Talha has demonstrated understanding of this outcome by giving examples from his clinical practice. He is a very confident student and
enjoys taking a leadership role with his peers.

5. PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES

5. 1 Incorporate the clients unique needs and expected outcomes into holistic and client-

Satisfactory

Satisfactory

centred plans of
care.
T.Z.Z. : I was able to assess my clients unique needs that were lacking such as needing some to talk to who spoke the same language as
the client. Once I complete my assessments, I am able to create a client centered plan of care.

5. 2 Develop theory-based plans of care that are holistic and client centered and are

Satisfactory

Satisfactory

articulated competently in writing and orally.

T.Z.Z. : Critically thinking, Assessing, providing a Nursing Diagnosis, Planning, Implementing, Evaluating and theoretical knowledge are
some of the tools that I use to make client centered and holistic care plan/map.

E.W. : Three good concept maps with assessment data were submitted.

5. 3 Use knowledge, skill and judgment to assess clients, prioritize needs and outcomes.

Satisfactory

Satisfactory

T.Z.Z. : I use the theoretical knowledge and the data from my assessment to formulate my client's prioritize needs and outcomes.

5. 4 Collaborate in the evaluation and modification of plans of care.

Satisfactory

Satisfactory

T.Z.Z. : Consultation and collaboration are key in providing safe client care. For example, I collaborate with pharmacist when unsure about
a drug and drug comparability. My client had an order of a medication that he brought from home therefore it was not supplied by the
hospital (Potassium). However, my client's family member accidentally took that medication bag home. I brought this to the attention of the
staff nurse, M.D., and the pharmacist. In collaboration with the pharmacist, we were able to determine which Trade named medication
would be the same as pt.'s own medication, to be used as replacement. We procured appropriate orders that were necessary and made the
necessary adjustment to the plan of action.

5. 5 Safely and competently implement and evaluate nursing assessments and nursing

Satisfactory

Satisfactory

interventions in a manner that demonstrates knowledge and skill.

T.Z.Z. : I do a thorough assessment and I analyze the data collected with pt.'s baseline. When I recognize that someone is responding
unexpectedly, I will aid them or I seek help. When I complete vital signs, I will investigate the vital signs, try to understand their diagnosis
and comorbidities, and any tests or results that are available to me. When I see abnormalities I intervene appropriately and inform my staff
nurse, M.D. and instructor.

5. 6 Use the Three-Factor and practice decision-making frameworks to guide practice.

Satisfactory

Satisfactory

T.Z.Z. : I provided the best care that I could for clients by listening to their needs and advocating for them by telling my instructor and staff
nurse what the client needed if I could not provide this care myself. I also promote the best possible care by increasing my knowledge
about a nursing skill (intravenous therapy) that I had little phenomenology experience with.

5. 7 Prioritize nursing care and nursing interventions in order to manage workload, time, and
physical
resources.

Satisfactory

Satisfactory

T.Z.Z. : I do a thorough assessment and I analyze the data collected with pt.'s baseline. I base my intervention on the data. Once my
interventions are planned, I create a daily organization plan with helps me provide a competent and client centered care.

Teacher comments for PLANS OF CARE: MEET CLIENTS NEEDS AND MUTUALLY AGREED EXPECTED OUTCOMES :
Talha satisfactorily met this outcome. He developed good prioritization skills throughout the semester, once he gained experience in caring
for the surgical patient. He always collaborated well with the nursing staff regarding the care plan for his clients.

6. COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM

6. 1 Collaborate with clients and members of the inter-professional health care team to assess

Satisfactory

Satisfactory

clients, determine health needs, and to achieve mutually agreed expected outcomes.
T.Z.Z. : Consultation and collaboration are key in providing safe client care. I collaborate with other professional when ever I'm unsure or
want clarification regarding the plan of care. For example, I sought my instructor, staff nurse, resource nurse, pharmacist, physio therapist
and OT whenever I was unsure about a certain procedure, documentation category and/or method of approach; as mandated by Decisions
About Procedures and Authority (Revised 2014) and Disagreeing With the Plan of Care.

6. 2 Contribute as a member of the inter-professional health care team to respond to the

Satisfactory

Satisfactory

changing needs and expected outcomes of clients.

T.Z.Z. : I seek assistance appropriately and in a timely manner when I am unsure of something regarding a client. For example, I had a
client that I thought was becoming critical. I notified my preceptor that the clients vital signs were abnormal and that the blood-work from
the morning was also abnormal (low Hb).

6. 3 Seek out assistance and consult with members of the inter-professional health care team.

Satisfactory

Satisfactory

T.Z.Z. : When I require nursing resources, I either physically go to my instructor or faculty Professionals (staff nurse, resource nurse,
pharmacist, physio therapist, OT, etc).

6. 4 Use teamwork, consensus building, and conflict resolution skills to meet expected client

Satisfactory

Satisfactory

outcomes.
T.Z.Z. : I use teamwork in my nursing care by working as part of an interdisciplinary team. I work with other nurses, doctors,
physiotherapists, pharmacists, and many other professionals that are involved in the care of our patients. When working as part of an
interdisciplinary team, we are able to meet the desired client outcomes by working together as a team and ensuring that the clients are
always kept at the forefront of our care. I use conflict resolution skills when working both as part of an interdisciplinary team and when
working directly with clients. If a clients' wishes conflict with my own, I reflect upon my own values and beliefs and put the clients' decision
ahead of my values and beliefs. When I am working as part of a team, I use conflict resolution skills to ensure that the clients' wishes are
again at the forefront of their care. If a conflict arises, I handle it in an appropriate and professional manner.

6. 5 Use effective, collaborative, and consultative strategies to meet clients needs within a

Satisfactory

Satisfactory

changing
environment.
T.Z.Z. : I use effective, collaborative, and consultative strategies to meet client's needs within a changing environment. When I am
providing care for a client, I follow the CNO's Best Practice Guidelines. If I believe that something could be done better for a client I will
consult the appropriate interdisciplinary team. For example, if a client is on a diet that I disagree with, I will consult with speech and
language pathology. By consulting with a speech and language pathologist, I provide patient-centred care.

E.W. : And of course, you go through your staff nurse first (chain of command) because sometimes these issues have already been
addressed.

6. 6 Interact with members of the health care team respecting their unique role and

Satisfactory

Satisfactory

competencies.
T.Z.Z. : When interacting with the members of the health care team I respect their unique role and competencies. If I believe that a patient
could benefit from a consult with a speciality, I will consult them for assistance. Furthermore, I demonstrate a professional attitude when
communicating with other professions.

Teacher comments for COLLABORATIVE PRACTICE: INTERPROFESSIONAL HEALTH CARE TEAM :

Talha has given several examples for how he has met this outcome.

7. QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE

7. 1 Act in the best interests of clients and protect clients from harm through collaboration

Satisfactory

Satisfactory

and consultation with members of the inter-professional health care team and through
competent and safe practice.
T.Z.Z. : I act in the best interest of clients and protect them from harm by collaborating and consulting with the inter-professional health
care team through competent safe practice. For example, if I meet a client who is having difficulty transferring, I will consult with the
physiotherapists. By doing this, I have collaborated with an inter-professional team that understands how to mobilize patients in a more
effective manner than I do. The patient can be matched with the best mobility aid and falls can be prevented from occurring. By preventing
falls in the hospital I am also preventing longer hospitalizations and more complications for patients.

7. 2 Engage in ongoing reflective practice to identify strengths, areas for improvement; and,

Satisfactory

Satisfactory

integrate feedback into practice.

T.Z.Z. : I recognize my limits of practice when a client requires a treatment or procedure that I am not qualified to perform or am unsure
about, I consult with my instructor. I also recognize the limits of my practice when I only perform skills that I am comfortable with.

7. 3 Create, implement, and evaluate a learning plan consistent with the Quality Assurance

Satisfactory

Satisfactory

program (CNO).
T.Z.Z. : I ensure that my practice is consistent with standards of practice, guidelines, and legislation by reviewing the CNO, RPNAO and
RNAO best practice guidelines. For example, I review the best practice guidelines when learning about the most appropriate way to
implement change in the care plan.

E.W. : Talha submitted a new Learning Plan with goals to have effective reporting skills, improved organizational skills, and to be a better
advocate for quality learning.

7. 4 Seek out learning opportunities and feedback that foster professional development; and,

Satisfactory

Satisfactory

integrate these into practice.

T.Z.Z. : When I require nursing resources, I either physically go to my instructor or faculty advisor. Also, I use the resources provided at
William Ostler Hospital through the internet, in the hospitals library, or at the Humber library to access nursing journals that are pertinent
to my nursing practice.

7. 5 Use nursing research to foster professional development.

Satisfactory

Satisfactory

T.Z.Z. : I am using the research I have gained to provide competent care to clients at my placement. I find research to guide my practice.
When I do not understand a procedure, I look up the procedure in the hospital's policies and do research before conducting the procedure.
By doing this, I ensure that I am providing competent care.

7. 6 Use a theory-based approach and evidence-informed practice.

Satisfactory

Satisfactory

T.Z.Z. : I use my nursing knowledge and implement my knowledge with the clients at the placement. When I recognize that someone is
responding unexpectedly, I will aid them or I seek help. When I complete vital signs, I will investigate the vital signs, try to understand their
diagnosis and comorbidities, and any tests or results that are available to me.

7. 7 Apply knowledge of changes to the health care system, technology, and in society as

Satisfactory

Satisfactory

these affect nursing practice.

T.Z.Z. : I apply knowledge of changes to the health care system, technology, and in society as these affect nursing practice. For example,
the care plan is now been approached differently. Now I have to create care maps.

E.W. : Also, to decrease infection rates, all IV bags and tubing have to be labeled.

Teacher comments for QUALITY ASSURANCE: CONTINUE AND IMPROVE COMPETENCE :

Talha has met this outcome and has shown this by his clinical examples. He is a self-reflective student who does strive to use feedback
into his practice. He created a learning plan and has found many other learning opportunities on this surgical ward.

8. USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING

8. 1 Use critical thinking and problem-solving skills to inform decision-making in all aspects

Satisfactory

Satisfactory

of nursing care.
T.Z.Z. : I use critical thinking and problem solving to inform decision-making in all aspects of nursing care. Through my experience I am
able to critically think through situations and provide the best practice for my patients. When conducting a patient assessment, not only do
I conduct a head-to-toe assessment (intrinsic factors) I look at the extrinsic factors that are affecting the patients' well being. For example,
a patient that is diabetic that comes to the hospital often with reoccurring diabetic ketoacidosis may have extrinsic factors effecting their
need to be admitted. A patient may not be able to afford the medications. Another example of how I use critical thinking to inform all
aspects of nursing care is to conduct an assessment of my patient as well as their caregivers. Including a patient's family in their circle of
care is patient-centred care.

8. 2 Use critical thinking, problem-solving and decision-making skills to assess clients and to

Satisfactory

Satisfactory

determine nursing diagnoses, expected outcomes, nursing interventions, and evaluative

criteria.
T.Z.Z. : I have continued my competence in placement by making appropriate judgement about patients. For example, assessing a client
with pain, making a nursing diagnosis, and conducting nursing interventions.

8. 3 Evaluate critical thinking, problem-solving, and decision-making skills and design a plan
to improve
these.

Satisfactory

Satisfactory

T.Z.Z. : I evaluate my critical thinking, problem-solving, and decision-making skills by asking feed back from the staff nurse at the end of
each shift; and from my fellow HCPNSs and instructor for feed back through out the shift. After receiving feed back, I self-reflect and
implement the change where ever applicable.

8. 4 Integrate knowledge from a variety of nursing, health, and other theory into nursing

Satisfactory

Satisfactory

practice to provide safe and competent care.

T.Z.Z. : I provide a theoretical and/or evidence-based rationale for all decision in order to provide safe and competent care, because I have
researched and continue to research the most appropriate methods for nursing skills. For example, I have researched the best practice
with IV drug administration.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

T.Z.Z. : I critical think and problem-solve before making a decision. I prioritize in the following manner: ABC, physiological needs, safety,
and psycho-social need. For example, My client was verbalizing and displaying signs of pain; while taking about having no one to take care
of him outside the hospital and that he will be lonely outside the hospital. I focused on pain assessment and intervention before i assessed
is psycho-social state.

8. 6 Demonstrate professionalism and accountability.

Satisfactory

Satisfactory

T.Z.Z. : I demonstrate professionalism and accountability by taking action in situations where client safety and well-being is compromised.
For example, IF I see a nurse enter a patients room without washing or sanitizing their hands, I will ask them to wash or sanitizing their
hands before entering or exiting to provide patient safety and prevent the spread of infection. In addition, I take responsibility for my
actions.

8. 7 Use the practice decision-making and the nurse-client-environment frameworks to inform

Satisfactory

Satisfactory

and guide practice.

T.Z.Z. : I use the practice decision-making and the nurse-client-environment frameworks to inform and guide practice. for example, I
identify my own personal values in practice when I provide care. For example, I provide clients with care and include their families
regardless of their sex, gender, orientation, etc. I had a client with a transgender family member and I included the that member in care
appropriately. I also respect clients wishes when they decide to be a full code or a no code. I also respect clients wishes to receive or not
receive medications.

Teacher comments for USE CRITICAL THINKING, PROBLEM-SOLVING & DECISION-MAKING :

Talha has used critical thinking, problem solving and decision making into his practice with examples above.

Student Final Summary with Strategies for Continued Growth

I am improving my ability to manage multiple nursing interventions simultaneously when I am at placement. For example, I am able to assess vital
signs, do a head-to-toe assessment and administer medications appropriately for multiple clients. I am working on improving my time management
skills to provide this care. I recognize my limits of practice when a client requires a treatment or procedure that I am not qualified to perform or am
unsure about, I consult with my instructor. I also recognize the limits of my practice when I only perform skills that I am comfortable with.

Teacher Final Summary with Strategies for Continued Growth

Talha has met all the required nursing outcomes in this clinical semester. He has a mature attitude when caring for his clients and collaborating with
staff, peers, and his clinical teacher. His time management and organization skills have improved over the semester as he became familiar with caring
for the surgical patient.
Continue to practice good communication skills and go through the proper channels when you have concerns. Talha enjoys helping his peers and is
a true client advocate.
I wish you all the best, and have enjoyed having you in my clinical group.
Elaine Willard
December 16, 2015

Student's References
CNO.org
RPNAO.org
RNAO.org

Grade

Satisfactory

Unsatisfactory

Referred to Clinical Excellence Committee (CEC)

Grade

Satisfactory

Program Coordinator Feedback

The Program Coordinator has reviewed the evaluation

Yes

No

Student Sign Off

I met with my Clinical Teacher/Preceptor and discussed my evaluation

Yes

No

In general this evaluation accurately reflects my performance

Yes

No

Student Comment
Thank you